Utilization Review Nurse (RN)

Title: RN -- Review Analyst Location: Remote Duration: 12 months with possible extension Pay Range: $38.00 - $40.00 (Hourly) Shift: Monday -- Friday, 8am -5pm EST ** ** Key Highlights: - Perform prospective, concurrent, and retrospective utilization reviews for inpatient, outpatient, ambulatory, and ancillary services to determine medical necessity, appropriate length of stay, level of care, and intensity of services. - Review and process appeals submitted by providers, facilities, and members. - May develop care plans, conduct member outreach, and coordinate care across the healthcare continuum. - Preferred background includes Utilization Management (UM), Case Management, discharge planning, or utilization review. ** ** Qualifications: - 2-4 years of clinical experience. - Strong clinical background in ICU, ER, or Medical-Surgical units. - Requires a current, unrestricted Michigan RN license. - Above-average Microsoft Office/computer skills. - Bachelor's degree in Nursing or a related field preferred. ICONMA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law.